Applicant statement

I certify that I have read and understood all of this employment application. All information provided by me in support of my application is true and correct to the best of my knowledge. I voluntarily and knowingly authorize any former employer, person, firm, corporation, school or government agency, its officers, employees and agents to release any and all information concerning my former employment to this company , its officers, employees and agents, or any other person or entity making a written or oral request for such information on behalf of this company. I understand that the employment information may include, but is not necessarily limited to performance evaluations and reports, job descriptions, disciplinary reports, letters of reprimand, opinions and public record information regarding my suitability for employment possessed by it. I understand and agree that the hiring employer, as part of its evaluation of my employment application, may ask a company that provides reference checking services to assemble this information as well as information on my character through interviews (by telephone or written correspondence) or other contact with my references and others who may know me or may know about items of information requested, and that a report of this information may be made to this company . I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks that are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical and drug test.

I further certify t hat I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigate Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal. If hired, I agree to abide by all the rules and policies of the employer. In addition, I recognize that a copy of this authorization and release is as valid as the original and should be considered as such. I understand more information about this inquiry will be provided upon written request.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of myknowledge.